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Forming a part of <br />Policy Number: CBP9599O92 <br />Coverage Is Provided In PEERLESS INSURANCE COMPANY - A STOCK COMPANY <br />Named Insured: Agent: <br />EHS INTERNATIONAL INC CALIFORNIA COASTAL INSURANCE <br /> Agent Code:4293053 Agent Phone: (925)-866-7050 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -OWNERS, LESSEES OR <br />CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) Location(s) Of Covered Operatlone <br />Or Organizetlon(s): <br />ANY PERSON OR ORGANIZATION WHEN YOU AND SUCH PERSON OR <br />ORGANIZATION, ITS DEPARTMENTS, OFFICERS AND EMPLOYEES <br />ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT, <br />AGREEMENT OR PERMIT THAT SUCH PERSON OR ORGANIZATION <br />BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY TO <br />PROVIDE INSURANCE SUCH AS IS AFFORDED UNDER THIS <br />COVERAGE PART. <br />SCHEDULED LOCATION OF COVERED OPERATIONS: <br />ANY LOCATION AT WHICH YOU PERFORMED WORK DESCRIBED IN <br />WRITING IN THE CONTRACT, AGREEMENT OR PERMIT FOR A <br />PERSON OR ORGANIZATION THAT HAS BEEN QUALIFIED AS AN <br />ADDITIONAL INSURED IN THIS ENDORSEMENT. <br />Information required to complete this Schedule, if not shown above, will be shown In the Declarations. <br />A. Section II - Who Is An Insured is amended to Include as an additional Insured the person(s) or <br />organization(s) shown in the Schedule, but only with respect to liability for "bodily Injury", "property damage" or <br />"personal and advertising injury" caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of those acting on your behalf; <br />in the performance of your ongoing operations for the additional insureds) at the location(s) designated <br />above. <br />B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: <br />This insurance does not apply to "bodily Injury" or "property damage" occurring after: <br />1. All work, including materials, parts or equipment furnished In connection with such work, on the project <br />(other than service, maintenance or repairs) [o be performed by or on behalf of the additional Insureds) at <br />the location of the covered operations has been completed; or <br />2. That portion of "your work" out of which the Injury or damage arises has been put to Its Intended use by <br />any person or organization other than another contractor or subcontractor engaged In performing <br />operations for a principal as a part of the same project. <br />® ISO ProparUas, Inc., 2004 <br />__ ----CG_20-_10._07-.04----- --- -- ------- ---- - --- ---- ------ _ ------ --- ----- -- _--------...Page 1_of_1 __.---._ <br />OB/Ot/2012 9598092 NN189972 0205 PGDM080D J08945 GEONLYST 00000640 Pe9e 2t